The 2012 Anne Anastasi Graduate Student Poster Award winner

Religious coping in African-American and White women following pregnancy loss

Drexel University, Efrat Eichenbaum, MS; Mitra Khaksari, BS; Pamela A. Geller, PhD

The rate of stillbirth and miscarriage is approximately two times higher in African American women than non-Hispanic White women (MacDorman & Kirmeyer, 2009). However, the majority of studies concerning coping after pregnancy loss have featured middle-class, mostly White participants. Therefore, little is known about the emotional needs and coping resources of African American women following a pregnancy loss. The current study was designed to bridge this literature gap.

Religious coping (classified as positive or negative) is a common behavior following pregnancy loss (e.g., McGreal, et al., 1997, Pargament, Koeing, & Perez, 2002). Religion is a well-documented coping resource in African American women (e.g., El-Khoury, et al., 2004). Positive religious coping utilization in African American women has been identified in quantitative literature addressing pregnancy loss coping in this population (Kavanaugh & Hershberger, 2005; Van & Meleis, 2003).

The current study examined two hypotheses. We predicted that, compared with non-Hispanic White women, African American women will endorse: 1. greater rates of religious coping overall, and 2. higher levels of positive religious coping. 

Method

Participants

The participants in this study were women between ages 19 and 50, who experienced a pregnancy loss in the past six months to four years, and who identified as either White/Caucasian or Black/African American.

Procedure

Several recruitment sources and methods were utilized (e.g., Ob/Gyn clinics, churches, flyers, snowballing, social media). Most participants (> 85 percent) were recruited via the internet, including 88 percent of African American participants. Women participated in-person, over the telephone, or online. Measures included a demographics questionnaire and several quantitative instruments: Brief R-COPE (Pargament, Koeing, & Perez, 2002), Brief COPE (Carver, 1997), Ways of Coping Questionnaire – Revised (Folkman, Lazarus, Dunkel-Schetter, DeLongis, & Gruen, 1986) , and Hogan Grief Reactions Checklist (Hogan, Greenfield, & Schmidt, 2001).

Results

Data from 119 participants were analyzed via independent-samples t-tests. Results revealed that, compared to non-Hispanic White women, African American women (M = 3.21, SD = 1.02) reported significantly higher religious coping use compared with White women (M = 2.43, SD = 1.10), t(108) = -2.96, p < .01, r2 = 0.08. African American women also endorsed higher rates of positive religious coping (M = 3.07, SD = 0.93) compared with White women (M = 2.07, SD = 0.99). This difference was statistically significant, (105) = - 4.20, p < .01. Thus, both hypotheses were supported.

Discussion

After experiencing pregnancy loss, African American women were significantly more likely to engage in religious coping overall, and specifically positive religious coping, relative to White women. Several limitations restrict the generalizability of these results, including recruitment difficulties (particularly with African American women) and high rates of partial survey completion. Nevertheless, findings have implications for future research and for after-loss care providers serving African American women. For example, future research could investigate whether religious coping type (i.e., positive or negative) predicts mental health outcomes (e.g., depression, post-traumatic stress disorder) or quality of life following pregnancy loss. In addition, African American women’s utilization of positive and negative religious coping should be further assessed. Finally, clinicians and researchers may examine whether negative religious coping is amenable to intervention.

References

Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.

El‐Khoury, M., Dutton, M. A., Goodman, L. A., Engel, L., Belamaric, R. J., & Murphy, M. (2004). Ethnic differences in battered women’s formal help­seeking strategies: A focus on health, mental health, and spirituality. Cultural Diversity and Ethnic Minority Psychology, 10(4), 383–393.

Folkman, S., Lazarus, R. S., Dunkel‐Schetter, C., DeLongis, A., & Gruen, R. (1986). The dynamics of a stressful encounter: Cognitive appraisal, coping and encounter outcomes. Journal of Personality and Social Psychology, 50, 992-1003.

Hogan, N. S., Greenfield, D. B., & Schmidt, L. A. (2001). Development and validation of the Hogan Grief Reaction Checklist. Death Studies, 25, 1‐32.

Kavanaugh, K., & Hershberger, P. (2005). Perinatal loss in low income African American parents. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34(5), 595‐605.

MacDorman, M. F., & Kirmeyer, S. (2009). Fetal and perinatal mortality, United States, 2005. National Vital Statistics Reports, 57(8), 1-20.

McGreal, D., Evans, B. J., & Burrows, G. D. (1997). Gender differences in coping following pregnancy loss of a child through miscarriage or stillbirth: A pilot study. Stress Medicine, 13, 159-165.

Pargament, K. I., Koeing, H. G., & Perez, L. M. (2002). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56(4), 519-543.

Van, P., & Meleis, A. I. (2003). Coping with grief after involuntary pregnancy loss: Perspectives of African American women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32(1), 28-39.